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Business Office Financial Policies for Orthopaedic Specialty Group, PC

Thank you for choosing Orthopaedic Specialty Group for your care and treatment. Although billing is not always a comfortable topic, our financial policy is part of your overall treatment. To that end, the following is a summary of our policy.

Patient Responsibilities

Financial:
Method of payment: cash, personal check, VISA, MasterCard, Discover, and American Express.
Co-payment – the fixed dollar amount set by your insurance contract that is required to be paid by you at the time of the visit.
Deductible – the annual dollar amount set by your insurance contract that is deducted from insurance benefits and is required to be paid by you.  
Co-insurance – the percentage set by your insurance contract that is deducted from insurance benefits and is required to be paid by you.
Self-pay – the dollar amount to be paid by the patient who has no insurance benefits at the time of the visit.

Appointments:  
Demographics Intake Form: All information needs to be filled in completely – name, address, telephone, birth date, social security number, employer name, employer address, employer telephone, insurance carrier, insurance group number, insurance policy number, MVA or WC, etc., and sign and date at the bottom.

Day of Appointment - REMEMBER TO BRING:

  • Photo ID (i.e. driver’s license)
  • Your current insurance card(s)
  • Your co-pay as indicated in your insurance contract
  • Referral from your Primary Care Physician (PCP), if applicable
  • All completed paperwork, intake form, medical history form, etc.
  • Appropriate form of payment for those patients with no insurance

Motor Vehicle Accident (MVA)  
Please be sure to have contacted your automobile insurance carrier to get claim information, and bring the Declaration Page of your policy with you the day of the appointment. Your appointment may be canceled if this information has not been obtained. As a courtesy, we will bill your insurance carrier for the injury but we will also require your health insurance information.

Personal Injury
We require a financial arrangement be established for payment in full at the time of service. We will not be a party to any litigation suits being filed for personal injury.  (Letters of Protection)

Work-Related Injury (WC)
If you are being seen for a work-related accident, please do the following prior to your visit.
Contact your employer and/or workers’ compensation carrier, as we will require authorization that this occurrence is being accepted as a workers’ comp claim. We also require your health insurance information in the event that authorization is not obtained, or your claim is not approved (All co-pays, co-insurance, and/or deductibles will apply). Of course, you always have the option to make full payment at the time of service.

Overdue and In-collection Accounts
Patients with past due accounts will be asked to make payment in full before being seen in our office for anything other than surgical follow-up. Patient accounts sent to collection will not be allowed to schedule appointments until their account is paid in full.